STUDY DESIGN: Prospective case series OBJECTIVE.: To analyze the radiation exposure to the surgeons and patients in fluoroscopic-guided segmental pedicle screw placement for pediatric scoliosis SUMMARY OF BACKGROUND DATA.: Fluoroscopic-guided pedicle screw placement is a safer technique for pedicle screw placement in spinal deformity. However, radiation exposure is a concern, particularly for spine surgeons due to the requirement of multiple pedicle screws in spinal deformity surgery...

STUDY DESIGN: Analysis of a prospective multicenter database. OBJECTIVE: To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive ASD surgery compared with patients in the database used to create the index. SUMMARY OF BACKGROUND DATA: Accurate preoperative estimates of risk are necessary given the high complication rates currently associated with ASD surgery...

STUDY DESIGN: A retrospective, long-term follow-up study. OBJECTIVE: We aimed to clarify the predicting factors at skeletal maturity for future curve progression and low back pain (LBP) in adolescent idiopathic scoliosis (AIS) with thoracolumbar/lumbar (TL/L) curve. SUMMARY OF BACKGROUND DATA: TL/L curves are likely to progress after skeletal maturity and cause LBP. METHODS: Of 147 patients treated non-operatively for AIS with TL/L curve, 56 (55 females; average age at the time of survey, 39...

STUDY DESIGN: Objective and subjective fluoroscopic assessments of a new synthetic spine model. OBJECTIVE: To analyze the fluoroscopic performance and fidelity to human tissue of a new synthetic spine model. SUMMARY OF BACKGROUND DATA: The [blinded for review] Biomimetic Spine project aims to develop a 3-dimensional (3D) printed, synthetic spine model that will one day replace cadaveric tissue in spine biomechanical research. A crucial component to any biomimetic spine model is that it performs similarly to cadaveric tissue on standard diagnostic imaging modalities...

STUDY DESIGN: Cross-sectional case-control study. OBJECTIVE: To compare isolated lumbar extension strength between healthy asymptomatic participants and participants with chronic low back pain (CLBP), whilst controlling for previous lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Deconditioning of the lumbar musculature is common in those with previous lumbar surgery, resulting in decreased strength and endurance. Evidence is required to support whether this is the case for participants with CLBP yet no previous surgery compared with asymptomatic participants...

STUDY DESIGN: Prospective, multicenter, nationwide study OBJECTIVE.: To investigate perioperative complications and risk factors in surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) using data from the registry of the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. SUMMARY OF BACKGROUND DATA: There is no prospective multicenter study of surgical complications and risk factors for T-OPLL, and previous multicenter retrospective studies have lacked details...

STUDY DESIGN: A retrospective review of a prospectively collected multicenter database OBJECTIVE.: To assess the effect of proximal hooks vs. screws on proximal junctional kyphosis (PJK) as well as shoulder balance in otherwise all pedicle screw (>80%) posterior spinal fusion (PSF) constructs in adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Less rigid forms of fixation at the top of constructs in degenerative lumbar PSF have been postulated to decrease the risk of PJK...

STUDY DESIGN: A model experiment. OBJECTIVE: To measure and compare the clinical accuracy of point-to-point registration (PR) and auto-registration (AR) in an operative set using an active infrared navigation system. SUMMARY OF BACKGROUND DATA: PR and AR are two major registration methods of navigation assisted spinal surgery. No previous study compared the difference between the two methods with respect to clinical accuracy. METHODS: A novel method was used to measure the clinical accuracy of the navigation system under an operative set using a Sawbone model with titanium beads on the surface, which was essential to measure the accuracy numerically, instead of a real patient...

STUDY DESIGN: A comparative study of radiation dose measured in anthropomorphic phantoms. OBJECTIVES: First, to report the first organ dose and effective dose measurements in anthropomorphic phantoms using the new EOS imaging micro-dose protocol in full-spine examinations. Next, to compare these measurements of radiation dose to measurements in the EOS standard-dose protocol and CR. SUMMARY OF BACKGROUND DATA: Few studies evaluating organ dose and effective dose for the EOS low-dose scanner exists, and mainly for the standard-dose protocol...

STUDY DESIGN: Systematic review OBJECTIVE.: To determine the validity of the Hoffmann sign for the detection of degenerative cervical myelopathy (DCM) for patients presenting with cervical complaints. SUMMARY OF BACKGROUND DATA: While physical exam maneuvers are often used to diagnose DCM, no previous review has synthesized diagnostic accuracy data. METHODS: Medline, Embase and HealthStar were searched for articles from 1 January 1947 to 1 March 2017 using the following terms: Spinal Cord Diseases, Spinal Cord Compression, Cervical Vertebrae, Signs and Symptoms, Physical Examination, Epidemiologic studies, Epidemiologic Research Design, Predictive Value of Tests and Myelopathy...

STUDY DESIGN: Retrospective study of consecutive patients undergoing surgery for adult spinal deformity (ASD). OBJECTIVE: The aim of this study was to classify postoperative ASD patients by sagittal compensation and characterize the features of each group. SUMMARY OF BACKGROUND DATA: Sagittal compensatory mechanisms to keep the erect position would function in not only non-operative ASD patients, but also in postoperative patients. However, details of sagittal compensatory mechanisms after surgery have been unclear, because the majority of previous studies examined the compensatory mechanisms in non-operative patients METHODS...

STUDY DESIGN: A quality-control YouTube-based study using the recognized quality scoring systems. OBJECTIVE: In this study, our aim was to confirm the accuracy and quality of the information in kyphosis videos shared on YouTube. SUMMARY OF BACKGROUND DATA: The Internet is a widely and increasingly used source for obtaining medical information both by patients and clinicians. YouTube, in particular, manifests itself as a leading source with its ease of access to information and visual advantage for Internet users...

STUDY DESIGN: A retrospective epidemiological study. OBJECTIVE: To reveal the long-term survival and causes of death after traumatic spinal fracture (TSF) and to determine the possible factors predicting death. SUMMARY OF BACKGROUND DATA: Increased mortality following osteoporotic spinal fracture has been represented in several studies. Earlier studies concerning mortality after TSF have focused on specific types of fractures, or else only the mortality of the acute phases has been documented...